The Telemedicine Musculoskeletal Examination

Laskowski, Edward R.; Johnson, Shelby E.; Shelerud, Randy A.; Lee, Jason A.; Rabatin, Amy E.; Driscoll, Sherilyn W.; Moore, Brittany J.; Wainberg, Michael; Terzic, Carmen M.

doi:10.1016/j.mayocp.2020.05.026

Cited by 129 publications

(197 citation statements)

References 12 publications

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“…However, telemedicine is not new. To date, telemedicine has been tried and even regularly used in a variety of clinical situations such as stroke evaluation [6], psychiatric care [7], newborn resuscitation [8], multidisciplinary care [9], There are many resources available to guide some aspects of a telemedicine visit, including the American Telemedicine Association "Operating Procedures for Pediatric Telehealth" [15], an overview on adult rehabilitation telemedicine visits [16], telemedicine for pediatric gastroenterologists [17], and a how-to for the adult telemedicine musculoskeletal exam [18]. While these resources can help a PRM provider with telerehabilitation medicine visits for certain diagnoses or clinical scenarios, these resources do not provide specific guidance for pediatric telerehabilitation medicine.…”

Section: Introductionmentioning

confidence: 99%

Pediatric telerehabilitation medicine: Making your virtual visits efficient, effective and fun

Rabatin

Lynch

Severson

et al. 2020

PRM

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The COVID-19 pandemic has accelerated many changes in medicine including the transition from providing care in person to providing care via technology enabled telemedicine. The benefits of telemedicine visits with a Pediatric Rehabilitation Medicine (PRM) provider, also known as telerehabilitation medicine visits, are numerous. Telerehabilitation medicine provides an opportunity to deliver timely, patient and family-centric rehabilitation care while maintaining physical distance and reducing potential COVID-19 exposure for our patients, their caregivers and medical providers. Telerehabilitation medicine also allows for access to PRM care in rural areas or areas without medical specialty, virtual in-home equipment evaluation, and reduced travel burden. Because of these and many other benefits, telerehabilitation medicine will likely become part of our ongoing model of care if barriers to telemedicine continue to be lowered or removed. This paper is intended to establish a foundation for pediatric telerehabilitation medicine visit efficiency and effectiveness in our current environment and into the future.

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Section: Introductionmentioning

confidence: 99%

Pediatric telerehabilitation medicine: Making your virtual visits efficient, effective and fun

Rabatin

Lynch

Severson

et al. 2020

PRM

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“…A share screen function is a tool that allows the meeting host to present a document or image so that others can view it. This could be useful in a primary care setting using pre-prepared photos or videos [ 26 , 28 ], e.g., to show patients how to perform MSK tests which may otherwise be complicated to describe. Examination photos that may be helpful to demonstrate this for patients are discussed later under remote MSK examination.…”

Section: Resultsmentioning

confidence: 99%

Remote Musculoskeletal Assessment Framework: A Guide for Primary Care

Murray

2021

Cureus

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Introduction Remote consulting has exploded into primary care following the initial COVID-19 surge as a measure to reduce potential cross-infection (staff-patient or patient-patient). Musculoskeletal (MSK) conditions comprise up to 21% of the annual primary care caseload in England. Established techniques for MSK examination, however, rely on face-to-face attendance. Evidence-based guidance for remote MSK assessment is required to ensure the quality of care is maintained with the move from face-to-face to virtual consultations. Method A literature review of published evidence and current guidelines was conducted. The most appropriate remote consultation techniques and MSK examinations were identified and where there was no evidence, modified examination tests were developed from established face-to-face examination techniques. A concise, accessible framework for remote MSK assessment in primary care was then created and tested on a non-medically trained volunteer. Results Over 2232 papers and articles were identified by search headings, reducing to 28 sources that had relevant content. At the time of searching, there was no published evidence relating to MSK remote consultation in a primary care setting. However, evidence was found in the physiotherapy and rehabilitation literature for the efficacy and practicality of MSK teleconsultation. MSK remote examination framework From this literature and with the addition of modified established examinations, an MSK assessment framework was constructed. This framework provides pre-consultation guidance and step-by-step remote examination instructions. Patient and clinician resources (including a patient information leaflet and photographic examples of examinations) were created as supplementary material. Conclusion Due to the frameshift away from face-to-face consultation, primary care clinicians have found themselves lacking an evidence base or practical guidance to support remote MSK assessment. This paper is a systematic literature review of MSK telemedicine from which practical advice and evidence-based MSK tests have been developed. Where there is no evidence, modified traditional tests are suggested to allow a complete framework for remote MSK examination - using a system approach of ‘look, point, move’ followed by modified special tests, for use in a primary care setting as a ‘ready-to-use’ practical guide to remote MSK assessment, presented in a downloadable format. What did this add? With 21% of primary care consultations relating to MSK conditions and limited means of performing face-to-face MSK examination due to COVID-19, there needs to be a recognised framework for assessing the MSK system remotely. To the best of our knowledge, this evidence does not exist for primary care remote MSK examination. This paper demonstrates evidence-based practical advice (from non-primary care settings) and modified MSK examinations to be used in a pri...

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“…This barrier can be overcome by using evidence-based guidelines with clinical scoring, as reported in a prior study [24]. Some studies also suggest applying certain guidelines to virtual musculoskeletal examinations to overcome this barrier [25,26].…”

Section: Discussionmentioning

confidence: 99%

Telemedicine for Musculoskeletal Care During the COVID-19 Pandemic: Evaluating Readiness of Saudi Citizens

Alhamam¹,

Buhalim²,

Almakhayitah³

et al. 2021

Cureus

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Introduction: Since coronavirus disease 2019 (COVID-19) was announced as a global pandemic, it has become important to control the pandemic with several approaches, including limiting hospital visits. Telemedicine is a good option to help reduce in-person visits during the pandemic. Saudi Arabia has prepared for this pandemic by implementing applications, such as Tetamman and Seha. In this study, we aimed to determine the readiness of the Saudi population to use telemedicine for musculoskeletal care during the COVID-19 pandemic. Methods: A cross-sectional study was conducted from July 2020 to October 2020. The study used a predesigned, self-administered questionnaire with acceptable internal consistency (Cronbach's α=0.79). A questionnaire with 30 questions was distributed electronically and randomly to the Saudi population. The included participants were Arabic speakers, Saudis, and men or women age 18 years or older. Results: A total of 635 respondents, of which 250 were men (39.4%) and 385 were women (60.6%), completed the questionnaire. The most common region of residence was the Central region (41.6%), followed by the Eastern region (28%). The proportions of patients who had knowledge about virtual clinics and who used a virtual clinic during the COVID-19 pandemic were 47.6% and 30.4%, respectively. The mean overall attitude score was 24.4 (standard deviation, 9.9) of 35 points; negative, neutral, and positive attitudes were reported among 9.9%, 54.3%, and 35.7% of respondents, respectively. Compared with the older population, younger-aged participants (≤25 years) had significantly more positive attitudes about virtual clinics (χ 2 =6.068; p=0.048). Those respondents who had never been married showed significantly more positive attitudes about virtual clinics compared with those who had been married (χ 2 =6.695; p=0.035). Conclusions: The studied Saudi population shows a moderate level of acceptance of the concept of using telemedicine in musculoskeletal conditions, but some issues about patient access and understanding of the technology remain unaddressed.

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The Telemedicine Musculoskeletal Examination

Cited by 129 publications

References 12 publications

Pediatric telerehabilitation medicine: Making your virtual visits efficient, effective and fun

Pediatric telerehabilitation medicine: Making your virtual visits efficient, effective and fun

Remote Musculoskeletal Assessment Framework: A Guide for Primary Care

Telemedicine for Musculoskeletal Care During the COVID-19 Pandemic: Evaluating Readiness of Saudi Citizens

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